Clinical and Patient-Reported Outcomes in Non-English-Speaking Patients Undergoing Primary Total Knee Arthroplasty

Introduction Addressing disparities in patients undergoing total knee arthroplasty (TKA) is important for improving outcomes and resource utilization. Language barriers can adversely affect outcomes, though it is not clear whether the source of the disparity is language or a wider issue of racial, ethnic, or socioeconomic disparity. The purpose of this study was to compare short-term outcomes between English-speaking and non-English-speaking patients undergoing TKA. Methods A retrospective study of patients undergoing primary TKA within a single health system between January 2020 and December 2025 was performed. Non-English-speaking patients were propensity score matched 1:1 to English-speaking patients. After excluding patients lost to follow-up, 147 non-English-speaking and 140 English-speaking patients remained. Demographics, social vulnerability, clinical and patient-reported outcomes, and follow-up patterns were compared between groups. Results Non-English-speaking patients experienced clinical outcomes comparable to those of English-speaking patients across perioperative, 30-day, and one-year measures. There were no differences in response rates or scores on Patient-reported outcome measures (PROMs) between groups. Non-English-speaking patients generated significantly fewer patient-initiated MyChart (Epic Systems Corporation, Verona, Wisconsin, USA) electronic messages or telephone calls compared with English-speaking patients (1.6 ± 2.3 vs. 2.5 ± 4.1, p = 0.028). Additionally, non-English-speaking patients were significantly more likely to receive home physical therapy (20 (13.6%) vs. 5 (3.6%), p = 0.005). Conclusion Overall, non-English-speaking patients undergoing primary TKA achieved postoperative outcomes comparable to those of English-speaking patients despite demonstrating significantly greater social vulnerability. Additional studies are needed to replicate these results in a larger population and to identify any interventions that may prove beneficial in this population.